Management strategies for hyperemesis

Best Pract Res Clin Obstet Gynaecol. 2009 Aug;23(4):549-64. doi: 10.1016/j.bpobgyn.2008.12.012. Epub 2009 Mar 3.

Abstract

Nausea and vomiting occur in up to 80% of normal pregnancies. Hyperemesis gravidarum, resulting in dehydration and ketonuria, is a more severe, disabling and potentially life threatening condition affecting up to 1.5% of pregnancies. Treatment is supportive with intravenous rehydration, antiemetics and correction of vitamin deficiency to minimize complications. There are good safety data to support the use of antihistamines, phenothiazines and metoclopromide in hyperemesis gravidarum, though trials of efficacy are lacking and there is little evidence on which to chose the optimum therapy. This review discusses the diagnosis and management of hyperemesis gravidarum and the prevention, recognition and treatment of the serious complications of Wernicke encephalopathy, osmotic demyelination syndrome and thromboembolism.

Publication types

  • Review

MeSH terms

  • Antiemetics / therapeutic use
  • Dehydration / diagnosis
  • Dehydration / etiology
  • Dehydration / therapy
  • Female
  • Humans
  • Hyperemesis Gravidarum / diagnosis
  • Hyperemesis Gravidarum / etiology
  • Hyperemesis Gravidarum / therapy*
  • Infusions, Intravenous
  • Pregnancy
  • Pregnancy Outcome
  • Wernicke Encephalopathy / diagnosis
  • Wernicke Encephalopathy / etiology
  • Wernicke Encephalopathy / prevention & control

Substances

  • Antiemetics